Hania Arafa*, school teacher, wife and mother of two, suffered great loss in 2012. Her Aleppo home was destroyed, forcing the family to flee to Lattakia, a city nearly 200 kilometres away. During that long journey, two of her sisters died.

Since then, Hania has not worked. She’s been living in a shelter, with support from a local nongovernmental organization. Five months ago she told the doctor at the shelter that she was losing weight and eating less than she used to. She felt tired, had lost interest in all activities and was having difficulty falling asleep at night. She was no longer motivated to look for a new job to support her family.

Hania felt her life was no longer worth living.

Thankfully, the doctor at the shelter knew enough about mental health to diagnose Hania with depression and provide her with appropriate treatment. He had recently received training from the WHO Office in the Syrian Arab Republic on how to assess and manage common mental health conditions during emergencies.

Ambitious programme trains non-specialist health workers

In 2013, WHO Syrian Arab Republic initiated an ambitious programme to respond to the increasing needs for mental health care and psychosocial support in the country. It was evident that there were not enough mental health-care specialists to address the emerging needs. WHO estimates that approximately 600 000 people in the Syrian Arab Republic are suffering from severe mental health disorders and another 4 million from mild to moderate mental disorders.

Using WHO’s mhGAP Intervention Guide for treating people with mental, neurological and substance use disorders in non-specialized health settings, more than 500 non-specialist health-care professionals have since been trained in the Syrian Arab Republic to provide support for mental disorders.

During emergencies, grief and acute distress affect most people, both children and adults. For some, however, extreme adversity triggers more serious conditions such as depression. These conditions make it difficult for people to carry out everyday tasks. “In emergencies, whether they be a result of conflict or natural disaster, the needs for mental health care increase with every day that goes by,” says Dr Mark van Ommeren, Public Mental Health Adviser at WHO. “Yet in these situations, access to care for treating mental disorders is usually extremely limited.”

New guide for humanitarian emergencies

WHO, together with the UN Refugee Agency, UNHCR, is now releasing the mhGAP Humanitarian Intervention Guide. Adapted from the original version, this guide is specifically targeted at generalist health professionals working in humanitarian emergencies.

“This simple, practical tool will help scale-up the support that we can provide to people suffering from mental distress in the Syrian Arab Republic. It is eagerly awaited,” says Elizabeth Hoff, the WHO Representative to the Syrian Arab Republic.

Worldwide, close to 80 million people are currently impacted by humanitarian emergencies arising from natural disasters and armed conflicts. WHO estimates that 5-10% of these people suffer from a mental health condition such as depression as a result of the emergency.